In some instances, it may be desirable to implant a device within or adjacent to a wall of a patient's paranasal sinus. Paranasal sinuses include ostia for providing fluid communication to and from the sinus and the nasal cavity. In particular, such ostia may provide paths for communication of mucus from the sinus to the nasal cavity; and of air/medication/etc. from the nasal cavity to the sinus. In some instances, it may be desirable to provide an implant that promotes or enhances the communication of mucus from the sinus to the nasal cavity, that promotes or enhances the communication of air from the nasal cavity to the sinus, and/or that promotes or enhances the communication of medication or other substances from the nasal cavity to the sinus.
If a naturally occurring ostium is blocked, functionally closed due to mucosal thickening, or otherwise not sufficiently open, the ostium may be dilated before deploying an implant in the ostium. One method of dilating an ostium includes using a guidewire and catheter to position an inflatable balloon within the anatomical passageway, then inflating the balloon with a fluid (e.g., saline) to dilate the anatomical passageway. For instance, the expandable balloon may be positioned within an ostium at a paranasal sinus and then be inflated, to thereby dilate the ostium by remodeling the bone adjacent to the ostium, without requiring incision of the mucosa or removal of any bone. Examples of such dilation systems are disclosed in U.S. Pub. No. 2011/0004057, now abandoned, entitled “Systems and Methods for Transnasal Dilation of Passageways in the Ear, Nose or Throat,” published Jan. 6, 2011, the disclosure of which is incorporated by reference herein. Another example of such a system is the Relieva® Spin Balloon Sinuplasty™ System by Acclarent, Inc. of Menlo Park, Calif. Exemplary balloon dilator catheters include the Relieva Ultirra™ Sinus Balloon Catheter and the, both by Acclarent, Inc. of Menlo Park, Calif. An exemplary guide catheter that may be used to position a balloon catheter is the Relieva Flex™ Sinus Guide Catheter by Acclarent, Inc. of Menlo Park, Calif. Examples of devices that may be used to inflate a balloon of a dilation catheter are disclosed in U.S. patent application Ser. No. 14/020,924, titled “Inflator for Dilation of Anatomical Passageway,” filed Sep. 9, 2013, published as U.S. Pat. Pub. No. 2014/0074141 on Mar. 13, 2014, issued as U.S. Pat. No. 9,962,530 on May 8, 2018, the disclosure of which is incorporated by reference herein.
In some instances, it may be desirable to create an ostium in a sinus. This may be done with a cutting device that is operable to cut through bone and tissue or otherwise form an opening in a sinus wall. Examples of such devices are disclosed in U.S. patent application Ser. No. 14/038,867, entitled “Apparatus and Method for Treatment of Ethmoid Sinusitis,” filed on Sep. 27, 2013, published as U.S. Pat. Pub. No. 2014/0277039 on Sep. 18, 2014, now abandoned, the disclosure of which is incorporated by reference herein. When an ostium is formed using a cutting device, the ostium may be further enlarged by a balloon dilation device or using other devices/techniques.
A variable direction view endoscope may be used to provide visualization within the nasal cavity to position a dilation catheter, a cutting device, and/or an implant at a desired location. A variable direction view endoscope may enable viewing along a variety of transverse viewing angles without having to flex the shaft of the endoscope within the nasal cavity. Such an endoscope that may be provided in accordance with the teachings of U.S. Pub. No. 2010/0030031, entitled “Swing Prism Endoscope,” published Feb. 4, 2010, now abandoned, the disclosure of which is incorporated by reference herein. An example of such an endoscope is the Acclarent Cyclops™ Multi-Angle Endoscope by Acclarent, Inc. of Menlo Park, Calif. In some instances where a balloon dilation catheter is used, an illuminating guidewire may also be used to provide confirmation of the proper positioning of the catheter before inflating the balloon. Such a guidewire may be positioned within the target area and then illuminated, with light projecting from the distal end of the guidewire. This light may illuminate the adjacent tissue and thus be visible to the naked eye from outside the patient through transcutaneous illumination. For instance, when the distal end is positioned in the maxillary sinus, the light may be visible through the patient's cheek. Using such external visualization to confirm the position of the guidewire, the balloon may then be advanced distally along the guidewire into position at the dilation site. Such an illuminating guidewire may be provided in accordance with the teachings of U.S. Pub. No. 2012/0078118, entitled “Sinus Illumination Lightwire Device,” published Mar. 29, 2012, now U.S. Pat. No. 9,155,492, issued Oct. 13, 2015, the disclosure of which is incorporated by reference herein. An example of such an illuminating guidewire is the Relieva Luma Sentry™ Sinus Illumination System by Acclarent, Inc. of Menlo Park, Calif.
While several instruments and procedures have been made and used for treatment of anatomical passageways in a patient, it is believed that no one prior to the inventors has made or used the invention described in the appended claims.
The drawings are not intended to be limiting in any way, and it is contemplated that various embodiments of the invention may be carried out in a variety of other ways, including those not necessarily depicted in the drawings. The accompanying drawings incorporated in and forming a part of the specification illustrate several aspects of the present invention, and together with the description serve to explain the principles of the invention; it being understood, however, that this invention is not limited to the precise arrangements shown.